Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 30-022824 | OH |
N | 213EG0000X | General Practice | 30-022824 | OH |
Y | 1223P0221X | Pediatric Dentist | 26303 | TX |
NPI | 1013170133 |
---|---|
Provider Name | Dr. Brian Hatch |
First Address | Frisco, TX 75034-7693 |
Second Address | Frisco, TX 75035-5802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 22/06/2011 |